The effect of video-based games on upper extremity function and activity participation in children with hemiparetic cerebral palsy

Background and objective Upper extremity dysfunction and limited participation in daily activities are common in children with hemiparetic cerebral palsy and may restrict independence and social engagement. Interactive video-based rehabilitation has emerged as a promising adjunct to conventional therapy. This study aimed to evaluate whether motion-detection video games (Microsoft Xbox Kinect) combined with neurodevelopmental therapy (NDT) provide additional benefits in upper extremity function and activity participation compared with NDT alone.Methods This randomized controlled study included children aged 7–13 years with hemiparetic cerebral palsy classified as Levels I–III according to the Gross Motor Function Classification System and Levels 1–3 on the Manual Ability Classification System. Participants were randomly assigned to an intervention group receiving combined NDT and video-game–based training or a control group receiving only NDT for 12 weeks. The study was conducted at Özel İlk Yankı Special Education and Rehabilitation Center. Outcomes included hand function assessed by the Nine-Hole Peg Test (9HPT) and Duruöz Hand Index (DHI), and activity participation assessed by the Assistance to Participation Scale (APS). Assessments were performed at baseline and post-intervention by a blinded physiotherapist. Data were analyzed using parametric tests, and effect sizes were calculated. Results A total of 24 participants completed the study (n = 12 per group). Both groups demonstrated significant within-group improvements in APS, DHI, and 9HPT scores (p < .05). Between-group comparisons revealed significantly greater improvements in the intervention group for APS (p = .043) and DHI (p = .049), with large effect sizes (d = 0.87 and d = 0.84, respectively). No statistically significant between-group difference was observed for 9HPT (p = .096), although a moderate effect size (d = 0.71) was detected.Conclusion The addition of video-based gaming to conventional NDT may provide additional benefits in functional hand use and activity participation in children with hemiparetic cerebral palsy when delivered within a matched therapy dosage framework. Although no significant between-group difference was observed in fine motor performance, the moderate effect size suggests a potential effect that may not have reached statistical significance. Video-based gaming may be considered a feasible complementary approach in pediatric neurorehabilitation; however, further studies with larger sample sizes and long-term follow-up are warranted.ClinicalTrials. Gov NCT07421193; https://clinicaltrials.gov/study/NCT07421193